Healthcare Provider Details

I. General information

NPI: 1215662416
Provider Name (Legal Business Name): AMANDA GILMAN RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 CALEF HILL RD
TILTON NH
03276-5620
US

IV. Provider business mailing address

86 CALEF HILL RD
TILTON NH
03276-5620
US

V. Phone/Fax

Practice location:
  • Phone: 603-892-4907
  • Fax:
Mailing address:
  • Phone: 603-892-4907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number069854-21
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number069854-21
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: